CN106794020B - Extraction device for extracting foreign bodies from patients - Google Patents

Abstract

The invention relates to an extraction device (10) for extracting foreign bodies from a patient, comprising a flexible extractor (11), a reinforcing device (12) and connecting means (13) for connecting the flexible extractor (11) to the reinforcing device (12).

Description

Extraction device for extracting foreign bodies from patients

Background technique

The presence of stones in the kidney, or at the beginning of the ureter below the kidney, is a source of problems or symptoms such as pain, bleeding and infection, and it also poses a risk of obstruction of urine flow, eventual loss of kidney function and subsequent kidney destruction. Therefore these stones need to be removed. In fact, if treatment is not provided, patients will continue to have these problems, or will see them recur, and will suffer from complications.

Various treatments exist. The choice of technique depends primarily on the size, location, and hardness of the stone. Generally speaking, percutaneous nephrolithotomy is recommended for stones measuring more than 1 cm.

Percutaneous nephrolithotomy involves passing a nephrolithotomy through the skin and wall of the back directly into the kidney, allowing the stone or stones to be visualized and allowing the stone or stones to be removed. These stones are fragmented and the stone retrieval tool allows the capture and extraction of these stones from the patient.

Contents of the invention

The present disclosure relates to an instrument that can be used in situations where rigid nephroscopes must be used and also in situations where flexible nephroscopes are more suitable.

According to an embodiment of the invention, such an instrument may be reversible, that is to say it may be used again in its rigid configuration after it has been used in its flexible configuration, and vice versa.

An extraction device for extracting a foreign body from a patient is disclosed, the device having:

A flexible extractor formed by a flexible sheath, a drive stylet arranged in said flexible sheath, a handle, and a tool connected to the distal end of said drive stylet, the proximal end of said drive stylet a side zone is secured to the handle;

a reinforcement device with a rigid tube in which the flexible sheath of the flexible extractor can be placed; and

• Connection means for connecting the flexible extractor to said strengthening device.

Also disclosed is a strengthening device intended to cooperate with a flexible extractor, this strengthening device having a rigid tube capable of receiving a portion of said flexible extractor, and for connecting said strengthening device to said flexible extractor. connector on the device.

According to the present disclosure, the surgeon can use the device in a conventional manner in two different configurations. In a first configuration, the device may be used in a rigid nephroscope. In fact, surgeons usually begin by removing the largest stones with this type of nephroscope. In their rigid configuration, these rigid nephroscopes are generally shorter in length, as are the devices according to the invention. For this reason, the surgeon can use this device to work in the way he is accustomed to with conventional rigid nephroscopes.

In a second stage, the inventive device can be transformed into a flexible extractor if the surgeon wants to use a flexible device, especially for probing and/or removing stones or stone fragments from the other calyces of the kidney. It will be noted that flexible nephroscopes conventionally have a greater length than rigid nephroscopes. In one embodiment, this feature is observed so that the surgeon will also be able to work in a conventional manner while using the disclosed device in a configuration corresponding to a flexible nephroscope.

According to the present disclosure, the surgeon will be able to use a single device that can be flexible or rigid depending on the needs of the moment. Moreover, he will be able to use this device with conventional appliances without having to adapt these. The surgeon will also be able to use this device in the same manner as the ones he is used to, which avoids the need to learn new techniques and reduces the attendant risks.

Description of drawings

The invention and its advantages will be better understood with reference to the detailed description of specific embodiments and with reference to the accompanying drawings, in which:

- Figure 1 is a perspective view of a flexible extractor according to one embodiment;

- Figure 2 shows a reinforcement device according to an embodiment;

- Figure 3 is a perspective view of an extraction device according to an embodiment;

- Figure 4 shows details of elements according to an embodiment; and

- Figure 5 shows another detail of the device according to one embodiment.

Detailed ways

Referring to the accompanying drawings, there is disclosed an extraction device 10 for extracting foreign matter from a patient, especially an extraction device for extracting stones from a patient's body. This extraction device essentially consists of two elements, the flexible extractor 11 and the reinforcement means 12 . The extraction device 10 according to the invention also has connection means 13 for connecting the flexible extractor 11 to the stiffening device 12 .

The flexible extractor 11 has a flexible sheath 14 rigidly connected to the handle 15 , and a drive stylet 16 also rigidly connected to the handle 15 . The drive stylet 16 is flexible and slides within the flexible sheath 14 .

The handle 15 has a substantially U-like shape and has a distal portion 17 to which the flexible sheath 14 is secured and a proximal portion 18 to which the drive stylet 16 is secured. The distal part 17 and the proximal part 18 of the handle are movable relative to each other. According to one embodiment, the relative movement of the two parts of the handle is achieved by means of the elasticity of the material from which this handle is made. This material may advantageously be a polymer such as polyamide, POM (polyoxymethylene), polycarbonate or ABS (acrylonitrile butadiene styrene). Other suitable materials may also be used. Obviously other assembly methods can be used, for example an assembly in which a hinge in the lower part of the U-shaped piece connects the distal part 17 with the proximal part 18 of the handle. This method of assembly also permits relative movement of the distal and proximal portions of the handle. Many variations of this handle can be used, for example, a handle with a syringe-style pusher.

Drive stylet 16 is rigidly connected at its distal end away from handle 15 to a tool (not shown). According to one embodiment, the tool may be a lithotrix, allowing the stone to be grasped and extracted from the patient's body. Depending on the application, other tools can obviously be used.

The drive stylet 16 can adopt two extreme positions, a retracted position in which the distal end of the drive stylet 16 and the tool are also located within the flexible sheath 14 and an operative position in which On, the tool is outside this sheath 14.

According to one embodiment, the handle 15 is designed such that the drive stylet 16 is in the retracted position when no force is applied to the handle.

The handle 15 also has a part of a connection means 13 for connecting the flexible extractor 11 to said strengthening device 12 . For this purpose, the distal part 17 of the handle has a longitudinal slit 19, the purpose of which is explained in more detail below. The handle 15 also has elastic tabs 20 each provided with a lug 21 .

According to one embodiment, the proximal end of the drive stylet 16 is non-detachably secured to the handle 15 . Given the flexibility of the drive stylet 16, non-removable fastenings may be used. However, this stylet must be chosen such that it bends when the handle is moved from the retracted position to the working position, while at the same time folding in the fastening area to the handle.

In one embodiment, the length of the flexible sheath 14 is such that the flexible extractor 11 can be used with conventional instruments, in particular with nephroscopes or flexible endoscopes. This length is usually between 40cm and 120cm.

The strengthening device 12 essentially comprises a rigid tube 22 , a diverting member 23 , and a part of connection means 13 for connecting the flexible extractor 11 to said strengthening device 12 . The rigid tube 22 has an internal passage 24 having a diameter such that the flexible sheath 14 of the flexible extractor 11 can be introduced therein. This rigid tube 22 is advantageously of a size corresponding to conventionally used rigid nephroscopes. The length of the rigid nephroscope is typically between 20 cm and 40 cm for an inner diameter between 1 mm and 6 mm. The rigid tube may be made of metal such as medical grade stainless steel such as Type 316 steel or a suitable alloy, or of a polymer such as a polymer reinforced with carbon fiber, glass fiber or Kevlar . Other suitable materials may also be used.

In one embodiment shown, the diverting member 23 is formed by a ring, an internal channel 24 of sufficient size to allow the passage of the sheath 14 of the flexible extractor 11 .

When the diverting member 23 has a circular shape, the length of the ring, or the circumference of the diverting member, is substantially equal to the difference between the length of the rigid tube 22 and the length of the flexible sheath 14, as explained in more detail below.

As illustrated in FIGS. 3-5 , the steering member 23 has a cover 25 that permits access to and from the interior passage 24 . This makes it easier to place the flexible sheath 14 in this steering member 23 .

According to one embodiment, the steering member 23 has a thickness and a position such that a part of this member can be placed in the longitudinal slot 19 of the handle 15 . It should be noted that this steering member can be placed in a position separate from the handle 15 so that the two elements do not come into contact with each other.

The stiffener 12 has a retaining member 26 in which the rigid tube 22 is secured. This holding member 26 is provided with notches 27 designed to cooperate with the lugs 21 of the handle 15 .

It is well known to those skilled in the art that a surgeon seeking to remove foreign bodies from a patient, in particular stones from a patient's kidney, may use the technique known as percutaneous nephrolithotomy already mentioned above. In this technique, a passage is made through the patient's back to the kidney and stones can be removed from the kidney. In most cases, the surgeon uses a rigid nephroscope to palpate the stone approximately in the continuation of the nephroscope. For stones located elsewhere than in the continuation of the nephroscope, for example, in the other calyces of the kidney, the surgeon uses a flexible nephroscope.

According to the present disclosure, extraction device 10 may first be used as a conventional rigid nephroscope. To this end, the flexible sheath 14 is first introduced into the inner channel 24 of the steering member 23 . In order to do this, the flexible sheath can simply be pushed into the steering member 23, shaped so that the sheath does not enter the rigid tube 22 directly, but first passes into this tube before emerging from the inner channel 24 and into the rigid tube 22. channel. If the steering member 23 has a cover 25, this can optionally be removed to facilitate placement of the flexible sheath 14, if necessary.

This flexible sheath 14 is then pushed into its extreme position in which the tool placed at the end of the drive stylet 16 of the flexible extractor 11 is arranged near the free end of the rigid tube 22 .

In this position, the different parts forming the connection means 13 engage in such a way as to keep the flexible extractor rigidly connected to the strengthening means. More precisely, the diverting member 23 of the strengthening device 12 engages in the longitudinal slit 19 of the handle 15 of the flexible extractor. The lug 21 formed on the elastic tab 20 of the handle 15 engages in the notch 27 of the holding member 26 . In this way, the flexible extractor 11 and the stiffening means 12 are rigidly connected and can be used in the same way as conventional rigid extractors. Actuation of the handle 15 has the effect of moving the drive stylet 16 , which permits actuation of a tool arranged at the tip of this drive stylet. The elasticity of the handle 15 is such that, when no force is exerted on this handle, the tool is arranged within the flexible sheath 14 and within the rigid tube 22 .

When the surgeon wants to use the extraction device 10 in a flexible nephroscope, he unrolls the elastic tab 20 , which has the effect of releasing the lug 21 from the holding member 26 . The surgeon removes the steering member 23 from the longitudinal slot 19 of the handle 15 and pulls the flexible sheath 14 from the rigid tube 22 . In this configuration, the entire length of the flexible sheath 14 can then be used, thereby making it possible to use this extractor 11 with conventional flexible nephroscopes.

If the surgeon wishes to reuse the extraction device 10 in its configuration as a rigid extractor, it is sufficient to reintroduce the flexible sheath 14 into the steering member 23 and reposition this steering member 23 in the longitudinal slit 19 of the handle 15 and reposition the lug 21 on the retaining member 26.

The present disclosure thus makes available in a single extraction device a configuration corresponding to a flexible nephroscope and a configuration corresponding to a rigid nephroscope. In one embodiment, the device is generally reversible, which allows the surgeon at any time to choose the configuration that best suits the situation. The device according to the present disclosure is also dimensioned in such a way as to correspond to the dimensions of conventional flexible or rigid nephroscopes, which means that the device according to the invention can be used with conventional instruments without having to develop other instruments on the one hand, and Surgeons, on the other hand, don't have to be familiar with other instruments or other ways of working. However, it is possible to provide the extraction device without the diverting member 23 . In this case, the length of the device according to the invention is substantially the same in its flexible configuration and in its rigid configuration.

In the example shown, the connection means 13 is formed in particular by the handle 15 and the steering device 23 . The handle and the steering device may also be independent of each other and not form part of the connected appliance.

Irreversible linking devices can also be used. In this case, the connection means can be broken eg at a disconnection zone in order to separate the reinforcing means from the flexible extractor without any possibility of reconnecting the reinforcing means to the flexible extractor.

The present disclosure describes the use to remove stones from a patient's kidney. The same principle can be applied to other foreign bodies removed from patients.

Claims (10)

1. the extraction element (10) for extracting foreign matter from patient, this device are characterized in that it is included

● by flexible shroud (14), the transmission stylet (16) being arranged in the flexible shroud (14), handle (15), Yi Jilian It is connected to the flexible extractor (11) that the tool of the distal end of transmission stylet (16) is formed, it is described to be driven the close of stylet (16) Lateral areas is fixed on the handle；

● the stiffening device (12) with rigid pipe (22), the flexible shroud (14) of the flexibility extractor (11) can be placed at In the rigid pipe；And

● for the flexibility extractor (11) to be connected to the connection apparatus (13) of the stiffening device (12),

Wherein, which has distal part (17) and portions of proximal (18), these distal parts and portions of proximal opposite In being moveable each other, the flexible shroud (14) is fixed to the distal part, and the transmission stylet (16) is fixed to The portions of proximal,

The handle (15) has longitudinal slit (19), this longitudinal slit forms a part of connection apparatus (13).

2. extraction element according to claim 1, which is characterized in that the transmission stylet (16) is in the flexible shroud (14) sliding in, and be characterized in that, the proximal region of transmission stylet (16) is rigidly connected to the handle (15).

3. extraction element according to claim 1, which is characterized in that the connection apparatus (13), which has, is rigidly connected to this The elastic contact pin (20) of at least one of handle (15).

4. extraction element according to claim 3, which is characterized in that the elasticity contact pin (20) is equipped with to be filled with the reinforcement Set at least one lug (21) of (12) cooperation.

5. extraction element according to claim 1, which is characterized in that the stiffening device (12) have can receive the flexibility The rigid pipe (22) of the flexible shroud (14) of extractor (11).

6. extraction element according to claim 1, which is characterized in that the stiffening device (12), which has, to be designed to connect Receive the flexibility extractor (11) the flexible shroud (14) a part steering component (23).

7. extraction element according to claim 4, which is characterized in that the stiffening device (12) has holding members (26), The holding members are rigidly connected on the rigid pipe (22) and have described for the flexibility extractor (11) to be connected to A part of the connection apparatus (13) on stiffening device (12).

8. extraction element according to claim 7, which is characterized in that the holding members (26) have be designed to At least one recess (27) of the lug (21) cooperation of the elasticity contact pin (20).

9. extraction element according to claim 6, which is characterized in that the steering component (23) is oriented and size is true It is fixed to keep the longitudinal direction for itself being located at the handle (15) narrow at when the flexibility extractor (11) is mounted in the stiffening device (12) It stitches in (19).

10. extraction element according to claim 6, which is characterized in that the steering component (23), which has, can receive this soft The inner passage (24) of a part of the flexible shroud (14) of property extractor (11).